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Association between Immediate Breast Reconstruction and the Development of Breast Cancer-Related Lymphedema

 Hong Bae Jeon  ;  Ji Hyuk Jung  ;  Sang Hee Im  ;  Yong Bae Kim  ;  Jee Suk Chang  ;  Seung Yong Song  ;  Dae Hyun Lew  ;  Tai Suk Roh  ;  Won Jai Lee  ;  Dong Won Lee 
 PLASTIC AND RECONSTRUCTIVE SURGERY, Vol.151(2) : 214e-222e, 2023-02 
Journal Title
Issue Date
Breast Cancer Lymphedema* / epidemiology ; Breast Cancer Lymphedema* / etiology ; Breast Neoplasms* / pathology ; Female ; Follow-Up Studies ; Humans ; Lymph Node Excision / adverse effects ; Lymphedema* / epidemiology ; Lymphedema* / etiology ; Lymphedema* / surgery ; Mammaplasty* / adverse effects ; Mammaplasty* / methods ; Mastectomy / adverse effects ; Mastectomy / methods ; Middle Aged ; Retrospective Studies ; Risk Factors
Background: With the increasing number of patients undergoing immediate breast reconstruction after mastectomy, the impact of immediate breast reconstruction on the risk of breast cancer-related lymphedema has become an emerging area of interest. This study aimed to identify the association between immediate breast reconstruction and postoperative lymphedema. Methods: A retrospective cohort study was conducted from 2006 to 2016 with 5900 consecutive patients who underwent mastectomy for primary breast cancer with or without immediate breast reconstruction. After excluding patients with synchronous contralateral breast cancer, lymphedema before mastectomy, history of procedures performed in the axillary region, and follow-up data of less than 1 year, the cumulative incidence of lymphedema after immediate breast reconstruction and after no reconstruction was calculated and compared using multivariate Cox regression analysis. Results: Overall, 5497 patients (mean age, 51.7 years) were included, and 630 developed lymphedema. The 5-year cumulative incidence rate of lymphedema was significantly reduced in patients who underwent immediate breast reconstruction versus control patients (9.6% versus 12.2%; P = 0.02). In the multivariate analysis, immediate breast reconstruction status (hazard ratio, 0.75; 95% confidence interval, 0.56 to 0.99; P = 0.042) was an independent predictor for lymphedema. Similar significant associations were observed in the subgroup analyses of patients with a body mass index less than 30 kg/m2(P = 0.024), in those with fewer than 10 dissected lymph nodes (P = 0.042), or in those with adjuvant radiotherapy (P = 0.048). Conclusions: Immediate breast reconstruction was associated with a reduced risk of lymphedema. These results may be used for predicting the development of lymphedema following breast reconstruction. CLINICAL QUESTION/LEVEL OF EVIDENCE: Risk, II. © 2023 Lippincott Williams and Wilkins. All rights reserved.
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1. College of Medicine (의과대학) > Dept. of Plastic and Reconstructive Surgery (성형외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Rehabilitation Medicine (재활의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Yong Bae(김용배) ORCID logo https://orcid.org/0000-0001-7573-6862
Roh, Tai Suk(노태석) ORCID logo https://orcid.org/0000-0001-8681-159X
Song, Seung Yong(송승용) ORCID logo https://orcid.org/0000-0002-3145-7463
Lew, Dae Hyun(유대현)
Lee, Dong Won(이동원) ORCID logo https://orcid.org/0000-0003-0046-3139
Lee, Won Jai(이원재) ORCID logo https://orcid.org/0000-0003-3056-0503
Im, Sang Hee(임상희) ORCID logo https://orcid.org/0000-0001-5128-5526
Chang, Jee Suk(장지석) ORCID logo https://orcid.org/0000-0001-7685-3382
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